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Pharm T5


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What is congestive heart failure?
The failure of the heart to adequately distribute blood to the tissues.
What may occur because of congestive heart failure?
Sodium and water are retained in an effort to compensate for inadequate cardiac output. Heart usually become enlarged.
What are some signs of congestive heart failure?
Coughing, fatigue, pulmonary edema, ascites, weight loss, extremities and abdomen distended.
What are the objectives of cardiovascular therapy?
1.To control rhythm disturbance (regular heartbeats) 2.Maintain or increase cardiac output (amount of blood pushed) 3.Relieve fluid accumulation (inside lungs or free body cavity) 4.Increase oxygenation of the blood (so it carries more O2)
How do you diagnose congestive heart failure? (3 things)
1.Physical signs 2.Supportive lab tests 3.X-ray/ultrasounds/ECG
What does basic therapy for congestive heart failure include?
Low salt diet (H/D or homemade), Diuretics, Digitalis, Vasodilators.
What do diuretics do?
They reduce pulmonary edema, ascites and cardiac workload. Remove fluid from the body via renal system.
What are the four types of diuretics?
"Loop", osmotic, methyl xanthines and thiazides.
What do loop diurectics do?
They inhibit Na resorption in the renal tubules.
Examples of loop diuretics.
Lasix (R), Disal (R)
List two trade names for furosemide.
Lasix (R), Disal (R)
What is the generic name for Lasix (R) and Disal (R)?
What do Lasix (R) and Disal (R) do?
They are loop diuretics
What do osmostic diuretics do?
They retain water in the renal tubules by osmotic action.
How do you administer osmotic diuretics?
Given IV over 10-15 mns.
What are osmotic diurectics used for?
Intracranail edema in trauma cases, not for cardiac.
What are two types of osmotic diuretics?
50% Glucose, Mannitol (hypertonic sugar)
What is the most common type of diurectic used in vet med?
"loop diuretics"
What does Digoxin do?
It improves cardiac contractility, decreases the heart rate, decreases signs of dyspnea and has an anti-arrhythmic effect.
What are two trade names for digoxin?
Lanoxin (R), Cardoxin (R).
What is the generic name for Lanoxin (R) and Cardoxin (R)?
What are some toxicity problems with digoxin?
Anorexia, vomiting, diarrhea, depression, increase excitability, and skipped heart beats (slowed down too much). Cats are more sensitive than dogs.
What do vasodilators do?
They dilate arteries and veins. Dilation of constricted arteries tends to decrease the cardiac workload and improves cardiac output.
What are some trade names for vasodilators?
Encard (R), Capoten (R), Vasotec (R) and Apresoline (R) (hydralazine).
What the goal for dietary management?
To restrict sodium intake and control debilitation and weight loss due to cardiac cachexia.
What are some ways to control dietary management?
1.Low salt diets 2.H/D 3.Diets also need to be balanced with adequte high-quality protein, simple sugars and emulsified fats.
What do expectorants do?
They enhance the expulsion of sticky secretions from the respiratory tract. Promot coughing.
What are some drugs used as expectorants?
Glyceryl guaiacolate (Guaifenesin (R)), acetylcysteine (Mucomyst (R)), Robitussin-AC (R), Triaminic (R).
What is the trade name for glyceryl guaiacolate?
Guaifenesin (R)
What is the trade name for acetylcysteine?
Mucomyst (R)
What specifically do expectorants do? 3 things
1.Have a local effect of mucous membranes 2.Decreases the adhesiveness of mucous secretions by making them more watery 3.Promotes the removal of the secretions (coughing, ciliary motion)
What do antitussive do?
They inhibit or suppress coughing.
What two groups are antitussives classified as?
Centrally or Peripherally acting.
What's the definition of a cough?
A reflex initiated by irritation to the upper respiratory tract.
What are the 4 groups of antitussives?
1.Bronchiodilators 2.Antihistamines 3.Corticosteroids 4.CNS Cough Center Depressents
What do bronchiodilators do?
They increase the diameter of the bronchioles.
An example of a bronchiodilator.
What is aminophyline? and what should it not be used with?
Bronchiodilator. Don't use with furosemide.
What type of bronchiodilator would you use in an emergency situation?
What do antihistamines do as an antitussive?
Decrese inflammation.
What do corticosteroids do as an antitussive?
Decrease inflammation.
List 3 CNS Cough Center Depressants.
Dextromethorphan, Codeine (Hycodan (R)), Butorphanol (Torbugesic (R), Torbutrol (R))
What CNS Cough Center Depressant is OTC?
Trade name for Codeine.
Hycodan (R)
Trade name for Butorphanol.
Torbugesic (R), Torbutrol(R)
What do methyl xanthines do?
They inhibit Na resorption by the proximal tubule. (a diuretic)
List an example of methyl xanthine.
What is methyl xanthine?
A diuretic.
List an example of thiazide.
Chlorthiazide (R)
Where does reabsortion occur with loop diuretics?
In the Loop of Henle.
What are some side effects of loop diuretics?
Increased excretion of chloride, potassium and water.
What is sometimes given to animals of long-term use of loop diuretics?
Potassium supplements.
How does enalapril (Enacard (R)) work?
It reduces the workload on the heart by dilating blood vessels, decrease blood pressure and may slow the progression of heart disease.
What's a side effect to enalapril (Enacard (R))?
It can worsen kidney disease.
What's a side effect to captopril (Capoten (R))?
Concurrent use of NSAIDS may decrease effectiveness of captopril.
Which vasodilator is a human drug, enalapril or captopril?
captopril (Capoten (R))
What are some side effects of vasodilators?
Vomiting, diarrhea and hypotension (decreases blood pressure).
What are two cardiac stimulants?
Epinephrine and Isoproterenol.
What does epinephrine do?
May initiate a heartbeat during CPR.
What does isoproterenol do?
It initiates heartbeat and strengthens contractions.
What would you use if you have cardiac arrest?
A cardiac stimulant. epinephrine, isoproterenol.
What are three antiarrhythmic drugs?
Lidocaine, procainamide, beta-blockers.
What is lidocaine used for?
For ventricular arrhythmias; IV only; short-acting.
What is procainamide used for?
It's similar to lidocaine, but it's longer-lasting and can be given orally.
What are beta-blockers used for?
To slow tachycardias and control some arrhythmias.
What is the trade name for beta-blocker?
Propranolol (R).
What do calcium channel blockers do?
The can slow heart rate, control arrhythmias, and decrease blood pressure (anti-hypertensive).
Two examples of calcium channel blockers.
Verapamil, diltiazem (Cardizem (R))-human.
What type of therapy might help for heart disease?
Oxygen cages or through the nose. Also avoid situations that may be physically and emotionally stressful for the animal.
What is guaifenesin used for?
Equine immobiliation with an IV drip to amintain anesthesia.
What is acetylecysteine (Musomyst (R)) an antidote for?
Acetaminophen toxicity.
What are the uses of butorphanol (Torbutrol (R))?
1.Preanesthetic for dogs/cats/hoofstock 2.Depresses CNS cough center 3.Relief of chronic cough in dogs
When would you not want to use a antitussive?
In cases of pneumonia.

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